Combined crushing and cutting unitary circumcision appliance



p 1954 J. T. LIVOTI COMBINED CRUSHING AND CUTTING UNITARY CIRCUMCISIONAPPLIANCE Filed June 10, 1953 GLANS PENIS FIG I JOSEPH T. LIVOT!INVENTOR I I BY I I I f in TTORN EY Patented Sept. 14 1954 UNITEDSTAT-ES PATENT OFFICE COMBINED CRUSHING AND CUTTING UNI- TARYCIRCUMCISION APPLIANCE Joseph T. Livoti, Brooklyn, N. Y. ApplicationJune 10, 1953, Serial No. 360;719

3 Claims. (Cl. 128-305) This invention relates to surgical instrumentsand more particularly to a combined crushing and cutting unitarycircumcision appliance.

An object of this invention is to provide an instrument forcircumferentially clamping the prepuce by exerting a crushing action sothat there will be no loss of blood, and to provide a duplexsemi-circular knife whereby a neat incision can easily be made. Anotherobject of this invention is to provide an instrument which not onlyinsures a bloodless operation but also serves to hold the foreskin infixed circular position to facilitate the cutting operation by a duplexset of semi-circular knives slidablymounted on the clamping portion ofthe instrument.

Another object of this invention is to mount the duplex knife on theclamping and crushing portion of the device and to use such clampingportion as a cutting guide for the duplex knife so that the prepuce maybe cut off flush with the upper surface ofthe clamping and crushingdevice.

Another object of this invention is to provide a modified rotary knifemounted on the upper surface of the skin crushing ring and arranged in amanner that the user may rotate this knife around a completecircumference and cut the prepuce flush with the upper surface of theskin crushing ring 23 with precision.

In the use of. prior art circumcision devices, it is customary to useascalpel or the like with which the prepuce is manually cut on flushwith the upper surface of a clamping ring, the quality of the cuttingoperation depending upon the manual skill of the practitioner, no twopractitioners having the same mechanical skill.

I propose to provide an instrument whereby a portion of the prepuce orfore-skin is crushed so as to prevent bleeding. The crushing element inmy instrument supports a movable knife which may be moved to cut theprepuce by circumscribing cutting means or by cutting means movablearound the crushed portion of the prepuce and so that bleeding isavoided after the completed circumcision operation.

"With the above and other objects in view, the invention-will behereinafter more particularly described, and the combination andarrangement 2 responding parts throughout the several views, in which:

Figure 1 is a front elevation, partly broken away and in cross-section,and on a greatly enlarged scale, showing the appliance assembled.

Figure 2 is a cross-sectional view taken on line 22 in Figure 1.

Figure 3 is a cross-sectional plan view similar to that shown in Figure2, but showing combined skin crushing and slidable cutting mechanismsupported below a housing.

Figure 4 is a front elevation partly broken away and in cross-section,of the combined mechanism shown inFigure 3.

Figure 5 is a cross-sectional plan view similar to that shown in Figure3 and showing a modified combined mechanism having'a form of rotaryknife.

Figure 6 is a central cross-sectional view of the mechanism shown inFigure 5.

In the illustrated embodiment of the invention, the numeral l0 indicatesa combined crushing and cutting unitary circumcision appliance,comprising a housing ll having a circular plate portion I 2 from whichextend two upright arms [3 which are joined together by a lateral.connecting member 1'4, and forming an inverted U -shaped upper portion.

In the connecting member 14 is a clearance aperture l5 serving toreceive the'threaded body portion I6 of a screw H. The screw H has anenlarged collar l8 and ahead IS. The collar I8 rests upon the connectingmember [4. A pin 20 passing through the threaded body portion I6 ispositioned at-thelower surface of the connecting member M. The screw I1is rotatably mounted in the connecting member I4.

- Mounted in contacting relation with the lower surface 22 of thehousing ll is a skin crushing ring 23 which has a circumferenceconsiderably smaller than the circumference of the lower plate portionl2 of the housing. A plurality of springs 24 are secured to the lowersurface of the plate I2 by screws 25. The free end lower portions of thesprings 24 are slightly curved and are angularly-positioned so that thecurved portionsengage the lower edge of the skin crushing ring and thussupport the skin crushing ring below the plate l2 of the housing.

It will be noted that the skin crushing ring23 has a circular aperture21 which tapers upwardly at its lower portion. The aperture 21terminates at itsupper end in a blunt skin crushing surface An aperture30 in the plate l2 allows passage portion of the rod 3| is threaded topermit the threaded body portion l6 of the screw I! to be threadedtherein. The lower portion of the rod 3| is threaded, the thread 32serving to secure a hollow bell-shaped body 33 against the said lowersurface. The body 33 has a threaded extension 34 threadably mounted inthe thread 32. It will be. noted that by rotating the head IQ of thescrew l1, that the rod 3| may be moved downwardlyor upwardly withrespect to the housing Suitably secured to the plate I2 of the housing His a plurality of flexible elongated members 36 preferably of ball typechain. The flexible members 33 depend from the plate and have springactuated skin clamps 3'! extending downwardly at their lower ends. I Theflexible members 36 are of a length to lower the skin clamps.

3! to the upper surface of the hollow bell-shaped body 33.

shaped body 33 is placed over the glans penis.

The prepuce is gripped by the skin clamps 31 and by adjusting thescrew'I7 is securely retained in position. The prepuce is clamped with a skin.crushing pressure between the internal surface of the crushing ring 23and the outer surface of the hollow bell-shaped body-33.

The skin crushing ring 23'is lowered over the bell-shaped body. The'ring has a screw 4|] threaded thereiniin a radial direction. The screw40 is threaded to cause a'high pressure and crushing action to beapplied over 'an annular portion of the prepuce. This skin portion iscrushed by the-applied high pressure and this permits a cutting actionof the prepucewithout loss'of blood. V Y

- The hollow bell-shaped body 33 has a number of-windows 4| at its upperportion for exposing the glans penis. The glans penis may thus be under.observation throughout the entire operation. I

As shown in Figure 2, it will be seen that the The head 50 has a groove5| in engagement with a bifurcated member 52 which is suitably fixed tothe plate l2. The knives are normally set and held in concentricrelation with the circular aperture 21 inthe ring 23' by rotating thescrew 48.

In operation, when using the combined device shown in Figures 3 and 4,the skin crushing ring 23' is applied on the prepuce by rotating thescrew 40. The screw 48 is then operated to bring the knives 45 and 45toward each other to exert a cutting action on the prepuce flush withthe upper surface of the skin crushing ring 23.

It is to be noted that the modified crushing ring 23' has two threadedapertures 53 in which two screws 54 are threadably mounted. The heads ofthe screws 54 engage and hold the knives 45 and 45 centrally with therod 3| and with the circular apertures 21 in the skin crushing ring 23'.The screws 54 and the bifurcated member 52 provide three points ofsupport for the knives while the knivesare adjusted for cutting Mountedon the modified skin crushing ring 23" is an inverted cup-shapedouter'member 6|] having an upright flange 6| in contacting relarod 3|has a keyway 42 lengthwise thereof and 5 that the plate portion I2hasa'key-43 which fits into the keyway. This arrangement preventsrelative rotation of the parts l2 and 3| during adjustment of the screwFigures 3 to 6 inclusive show two modified forms of theinventioncomprising combined skin crushing and cutting circumcision appliance inunitary for'm. r.

As shown in Figures 3 and 4=,-it will be seen the plate .|2 has leafsprings 24' which are longer than the springs 24 shown in Figure 1. Amodified skin crushing ring 23 is frictionally supported from the lowerend portion of the springs 24 in spaced-apart relation from the lowersurface of the plate I2.

slidably supported onthe upper surface of equally to or from eachother.

tion with the outer surface of the ring. The

cup-shaped member 6|! has a horizontal flange 62 in spaced-apartrelation from the upper surface of the ring 23", providinga circularcavity 63 in which an annular member 64 is adapted to freely rotatearound the entire circumference of the skin'crushing ring 23". a

Extending from the upper surface ofthe annular member 64 is a-boss65having an inclined slot 66 for a knife 61 which is positioned radiallyof the crushing ring. -'I'he knife 61 is retained in position to contactthe outer surface of the cupped portion of the bell-shaped body 33 whenthe crushing ring is clamped by the screw on the bell-shapedbodypthereby cutting a prepuce placed in operating position. A screw 68threaded in the boss 65 in positionfor clamping the knife 61 serves foradjusting and holding the knife in operating position.

In operation, when using the combined skin crushing and cutting-deviceshown in Figures 5 and 6, the skin crushing ring 23" is applied on theprepuce. The ring is clamped in position on the prepuce by turning thescrew 40-. The

user then rotates the knife 61 around the-prepuce and cuts the .prepuceflush vwiththe upper surfaceof the skin crushing ring 23",. 1

It is to be noted that Figures 2, 4 and 6. show the devices innon-operative .positionwith' the crushing rings held by the springs.

In operative position, the crushingring is'detached from the springs anddrops overpor ,on top ofthe hollow bell-shaped body 33 intogskincrushing position.

In accordance with the patentstatutes I have described and illustratedthepreferred embodiment of my invention, but it will be understood. thatvarious changes and modifications can. be. made therein withoutdepartingfrom thespirit. of the invention as claimsl I claim:

defined by the .appended,

described, a housing having an inverted U-shaped upper portion and acentrally apertured plate, a screw rotatably mounted in said upperportion in a manner as to prevent axial movement of said screw relativeto said housing, a rod having a thread for engagement with the threadedportion of said screw, and a female thread at its lower portion, abell-shaped member having a threaded extension for securing said memberto said rod, a plurality of flexible members depending from said plateand having skin clamps extending downwardly to said bell-shaped member,a skin crushing ring, springs secured to the lower surface of saidhousing plate, and having curved lower ends in engagement with saidcrushing ring and adapted to be spread apart to release said crushingring to permit said ring to be lowered over said bell-shaped member,said crushing ring having a screw threaded therein, whereby when saidcrushing ring is brought down over said bell-shaped body and over aprepuce mounted thereon, said screw may be threaded to cause a crushingaction on an annular portion of said prepuce to permit cutting of saidprepuce without loss of blood.

2. In a circumcision appliance of the character described, a housinghaving an inverted U-shaped upper portion and a centrally aperturedplate, a screw rotatably mounted in said upper portion in a manner as toprevent axial movement of U said screw relative to said housing, a rodhaving a thread for engagement with the threaded portion of said screw,and a female thread at its lower portion, said rod and said plate havingkey and keyway connecting means preventing relative rotation of saidparts, a bell-shaped member having a threaded extension for securingsaid member to said rod, a centrally apertured skin crushing ring, aplurality of flexible members depending from said plate and passingthrough said aperture in said ring and having skin clamps extendingdownwardly to said bell-shaped member, springs secured to the lowersurface of said housing plate, and having lower ends in engagement withsaid crushing ring and adapted to be spread apart to release saidcrushing ring to permit said ring to be lowered over said bellshapedmember, said crushing ring having a screw radially threaded therein,whereby ,when said crushing ring is brought down over said bell-shapedbody and over a prepuce mounted thereon, said screw may be threaded tocause a crushing action on an annular portion of said prepuce to permitcutting of said prepuce without loss of blood.

3. In a combined skin crushing and cutting circumcision appliance of thecharacter described, a housing having an inverted U-shaped upper portionand a centrally apertured plate, a screw rotatably mounted in said upperportion in a manner as to prevent axial movement of said screw relativeto said housing, a rod having a thread for engagement with the threadedportion of said screw, and a female thread at its lower portion, saidrod and said plate having key and keyway connecting means preventingrelative rotation of said parts, a bell-shaped member having a threadedextension for securing said member to said rod, a centrally aperturedskin crushing ring, a plurality of flexible members depending from saidplate and passing through said aperture in said ring and having skinclamps extending downwardly to said bell-shaped member, springs securedto the lower surface of said housing plate, and having lower ends inengagement with said crushing ring and adapted to be spread apart torelease said crushing ring to permit said ring to be lowered over saidbellshaped member, said crushing ring having a screw radially threadedtherein, whereby when said crushing ring is brought down over saidbellshaped body and over a prepuce mounted thereon, said screw may bethreaded to cause a crushing action on an annular portion of saidprepuce to permit cutting of said prepuce without loss of blood, and aknife movably mounted on said skin crushing ring and adapted for cuttingsaid prepuce flush with the upper surface of said skin crushing ring.

References Cited in the file of this patent UNITED STATES PATENTS NumberName Date 2,345,639 Tibone Apr. 4, 1944 2,376,893 Baker May 29, 1945

